Family Physicians’ Knowledge of and Comfort with Patients’ Sexual Health Concerns


R. Rollston
C. Brehm

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Sexual health affects many aspects of patient health; however, it is often not addressed with patients, and research shows that sexual health is not emphasized in medical education. Primary care providers ought to be on the front lines of the integration of sexual health into patient centered care. In rural areas, this responsibility often falls to family medicine physicians as patients do not have access to Ob/Gyns (obstetrician and gynecologist). The objective of this study was to assess the types and prevalence of sexual health concerns among patients in rural Appalachia and also to assess the comfort level of family medicine physicians in addressing and managing sexual health concerns. Sexual health was defined to include sexual wellness, infections, contraception, and sexual dysfunction. Participants included East Tennessee State University (ETSU) family medicine attending physicians (faculty physicians) and resident physicians at three designated ETSU residency clinic sites. We designed and distributed an eighteen-question survey to residents and faculty physicians in order to evaluate how the recently emerging sexual health emphasis has translated to the practice of family medicine in East Tennessee. Of note in the data analysis, the majority of providers reported they feel at least moderately comfortable discussing sexual health with patients. However, when asked how frequency they address sexual health with patients, most providers reported that they do not frequently ask patients about sexual health concerns. Even though the American College of Obstetrics and Gynecology (ACOG) recommends long-acting reversible contraceptives (LARCs) as first-line contraceptives, less than half of providers recommend LARCs to patients. Additional exploration is needed to address why most family medicine physicians do not ask patients about sexual health as well as to determine if any regional barriers exist. This data also suggests that family medicine providers often do not have the means to recommend first-line contraception, likely due to lack of access and/or lack of knowledge regarding current recommendations. This study suggests that more emphasis should be placed on addressing sexual health and there is a need for additional training perhaps through educational workshops, or the distribution of educational brochures, or training in LARC placement.


Johnson City, TN

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